What is Juvenile Diabetes? Juvenile diabetes is the onset of type 1 diabetes mellitus in children. Very much the same as the disease in adults, when a child has diabetes their bodies are unable to make enough insulin or they cannot make proper use of the insulin that is made. When a child has type 1 diabetes, daily insulin injections are necessary for the rest of their lives. Children are diagnosed with juvenile diabetes when their pancreas (the organ that produces insulin) does not make enough insulin on its own or not enough to process the food that is eaten into glucose. Glucose is how our bodies get energy from the food we eat. If a child's body is not processing the food the sugar (glucose) is spilled into the urine without being used for energy. Juvenile diabetes is also known as an autoimmune disease. The child's cells destroy the cells in the pancreas that are needed to make insulin. There are greater risks and complications associated with diabetes when it exists in young children. A good health care team and due diligence on the parents' part is going to be needed to ensure the child receives the best care possible. As a parent you will have to check your child's blood sugar levels regularly using a blood glucose monitor. It will also be your responsibility to ensure that a proper diet and regular physical activity are part of your child's life. It is important that other people who care for your child when you are not around know that he or she has diabetes. They need to know what to do in case of an emergency and the special dietary requirements your child requires. It is recommended to get a bracelet or other form of identification that your child can wear that advises they have juvenile diabetes. Finding out Your Child has Juvenile Diabetes It can be an emotional time when you find out that your child has been diagnosed with type 1 diabetes. You will wonder how this is going to affect your child emotionally and what it is going to mean for their future health. Your child is also going to be riding an emotional roller coaster. Depending on their age, they may or may not understand everything that is going on but they will understand that there are big changes being implemented. When a child is diagnosed with diabetes it affects the entire family. The day to day life of everyone may be changed. It will be a stressful time for but the best thing to do is to utilize the support available to you from your family, friends and health care providers. Educate yourself and your family and take it slow and easy. You are going to have a lot to learn and there is going to be a learning curve at the beginning. Not only do you need to learn how to give injections and monitor blood glucose levels but you will also have to plan very specific meals. But it can be done and after some time it will be second nature. Your whole family can benefit from the lifestyle changes that are going to be made. It may be especially hard for siblings but they will adjust just as everyone else will too. Eating a healthy well-balanced diet with plenty of exercise and physical activity is good for the entire family. Be there to support and listen to your child when they need it. They will be going through a range of emotions from anger to sadness and they are going to need their parents help during these times. If you keep a positive attitude and outlook they will too. Treatment for Juvenile Diabetes A child who is diagnosed with juvenile diabetes is going to need to follow a treatment plan for the rest of their life. But they will have a lot of support. And there have been many advances and improvements in the diabetic treatment industry in way of needles and monitoring devices. Knowing your child's blood sugar level is crucial to good control of the disease. By using a monitor at home you will see if the diet and insulin that is being provided is sufficient. There are many brands of monitors available and the amount of blood required is a very small drop placed on a strip. The monitor will come with a lancet device to draw the blood from a finger tip -- it is relatively painless and takes very little time. In order to replace or supplement the insulin in your child's body, a daily injection (sometimes more) is going to be required. In some cases a child will need more than one needle if the insulin from one is not lasting the entire day. You will learn how to monitor and adjust the level of insulin your child receives based on their blood glucose levels and advice from your doctor. The other part of treating diabetes in children is a balanced diet and plenty of physical activity. Follow the food guide for children and limit the amount of treats that they are given. Daily exercise will help children maintain a healthy weight which in turns helps to control their blood sugar by limiting the amount of insulin they need. After a little bit of time treating diabetes will be come a way of life for you and your child. Expect an adjustment period in the beginning but it will get better as you learn more and get the diabetes under control. Different Responsibilities to give Children with Diabetes The best way to help your child adjust to being a diabetic is to involve him or her in their treatment plan. Depending on their age and level of maturity the level that they are involved and what they can do will be different. Be aware that as children grow older, they are going to take more and more control over their disease and you have to know when it is time to step back and let them. For children three years of age and under, the management process is going to be solely in your hands. Even if there is a desire to do things on their own, their coordination skills and maturity level isn't where it needs to be to give themselves injections or test their own blood. As they are approaching the three year old mark, you may be able to involve them in decisions like which finger is to be used to test their blood or putting the strip into the monitor. Be on the look out for ways to include them as they become older and interested in doing so. As your child becomes a preschooler they are going to want to do everything on their own no matter what it is. Your child may begin to have more control over testing their blood but it still needs to be done under parental supervision. Insulin injections should still be handled by the parent at this age. Your child will have definite opinions on what they should be eating for meals. Give them options and let them decide what is going to be made for dinner. From the age of about eight years old and up, your child may be ready to give themselves their own injections. You will have to follow your child's and your own comfort level. Different Kinds of Insulin There are different brands of insulin that are available but in each brand there are two different kinds of insulin that are used to control juvenile diabetes. One is known as fast-acting insulin -- once it is injected it acts quickly in your child's system. The other type of insulin is called slow-acting or last-lasting and as the name implies it is in the child's system longer. For most people with diabetes a combination of the two types of insulin is required. They can be mixed together in one syringe or they can be taken separately at different times in the day. In children, the two different kinds of insulin will still react at different times for each individual. For some the fast-acting insulin will begin to work immediately and could be used up in a short period of time. In this case, they may have to have a second or even third injection of fast-acting insulin throughout the day. These are the children who may want to consider an insulin pump to reduce the number of injections they are having in a day. An insulin pump will also provide them with a steady amount of the fast-acting insulin as they need it. The long-acting insulin sits in a child's body for some time before it is put to use. The amount of time is going to vary by child. Ideally, once the fast-acting insulin has done its work, the long-acting insulin will take over keeping a steady supply of insulin. The combination of the two insulins and how they work together makes planning very important. After some time you will be able to determine how your child reacts to each of the different kinds of insulins. Planning meals and activities around how the insulin works is important not just when the injection is given. Complications Associated with Juvenile Diabetes As with any disease there are possible complications and side effects and juvenile diabetes is no exception. The risks and complications associated with this disease are serious but can be mitigated with careful monitoring and control of your child's blood sugars. All people that have been diagnosed with diabetes need to have their eyes checked on a regular basis. It is common to have eye problems that are known as diabetic retinopathy. This is when the blood vessels in the eyes are damaged because of raised continually raised blood sugars. Another complication is diabetic nephropathy. This is a problem that develops in the kidneys taking the form of degeneration or a complete shut-down. This is a very serious disease and should be kept in mind as an important reason to keep blood glucose levels under control at all times. If diabetic nephropathy does develop, it will usually occur later in adulthood but will require either dialysis or a transplant. Some more long-term effects children with diabetes are exposed to are heart disease, strokes, and hypoglycemia. But the severity of the complications and the likelihood of them occurring are dependant on how well the diabetes is controlled. Research continues everyday on ways to better treat and manage diabetes in children. As soon as your children are old enough to understand the disease, involve them in the management of keeping it under control. They need to learn what is needed of them when they become independent to live with diabetes and lessening the chances of suffering from severe complications. There have been big strides in the treatment of diabetes which has made it possible to delay our put off altogether some of the more troublesome problems. If you suspect that any of the above mentioned diseases are developing, consult with your doctor right away. Early detection is beneficial. A Juvenile Diabetic's Emergency Kit An emergency or first aid kit can be found in almost any home. But in a home where a child lives with juvenile diabetes there needs to be additional supplies for their needs. In addition to an at-home emergency kit, a child with diabetes should carry a portable kit with supplies with them at all times. There are going to be times when your child is going to need help to manage their diabetes and it may be an emergency situation because their blood sugar has dropped dangerously low. Your child should be wearing identification that advises everyone that they are diabetic and are taking insulin and a kit with the supplies needed to help them. The kit should include instructions on what to do in case of an emergency and numbers to call (parents and health care providers). In addition glucose tablets, fast-acting food stuff should be included to raise your child's blood sugar quickly. Good examples of these are juice boxes and hard candies. You should include a snack that is considered long-acting too. Something that will keep for a long time such as a granola bar is a convenient item to have. This is for situations where your child should be eating their next meal but unavoidably does not have access to food (in the car during a traffic jam or out with friends). For your home emergency kit, you should include a means to keep your child's insulin cold in the case of a prolonged power outage. A small cooler will work nicely for this. It is also a good idea to always have extra insulin on hand. Do not wait until you are out to pick up more, you never know when an emergency can happen that would prevent your from getting some -- be prepared. Checking for Ketones in Juvenile Diabetics Another part of the routine for monitoring and controlling juvenile diabetes is checking for the presence of ketones. This is done by dipping a stick available at drug stores into your child's urine. If ketones are present the end of the stick will turn a certain color. By matching the color of the stick with the legend on the container you can determine the level of ketones present. You should check for ketones first thing in the morning before your child eats (fasting). Give your child additional insulin and fluids if there are ketones present. Also, check again in a few hours and if the test is still positive you should check with your doctor for further instructions. When there are ketones in urine it is a sign that your child's body is not getting enough food and it is using fat stores for energy instead of food. Excessive ketones can lead to a condition known as ketoacidosis. This is a very serious condition and can even be life threatening. In addition to the presence of ketones you child may be very tired, have trouble breathing, and have stomach pains or nausea. Ketoacidosis will be present if your child's body does not have enough insulin to process the food he or she is eating or if they are not eating enough. The good thing about this condition is that it is easy to prevent with careful monitoring and by following a meal plan. If you discover ketones, it does not mean that your child has ketoacidosis. Increase the amount of insulin that is being given in addition to reviewing recent diet changes to try and rule out the reason for the ketones. As in all cases when you have questions about juvenile diabetes, contact your health care provider or diabetes educator. Celebrating Special Occasions and Juvenile Diabetes You may be worried about the long-term effects on your child once they are diagnosed with diabetes but their immediate concerns may be quite different. It is natural for them to focus on things they can't have anymore or might miss out on. Such as cake and ice cream at birthday parties, candy from Halloween, and a big dinner with pie at Thanksgiving and Christmas. But being diabetic does not mean that you have to abstain from all sweets all the time. Plan and plan some more. If you know that your child is going to be going to a birthday party on Saturday afternoon, alter their food intake for that day to allow them to have a small piece of cake. Until your children are much older, it is a good idea for you to stay with them at a birthday party in case of any emergencies. If there is a class party at the school, volunteer to make something that the class can share and your child can have safely. If your children's teachers are aware of the special dietary requirements they can include sugar-free treats on special occasions. The same holds true for Christmas and Thanksgiving as for birthday parties. Planning ahead and adjusting meals earlier in the day will allow your child to participate in all of the festivities at holiday time that revolve around food. There are many recipes and variations to recipes that are considered diabetic friendly. These include cakes, pies, and other desserts. There are things that can be done so your child does not feel deprived. It will make the transition smoother for everyone if you can continue on with life with only while integrated the changes needed for someone living with diabetes. But the allowances should not be made every day -- keep them to special occasions only. Having Juvenile Diabetes and Going to School The vital step after your child is diagnosed with juvenile diabetes is to develop a support network in the community. Your child's school should be at the top of this as a resource to tap into. Not only is it essential that the teachers at your child's school know about his special dietary needs and what to do in an emergency they can provide help in other ways too. In addition to good control of blood glucose levels to ensure the current and future wellbeing of your child's health, good control of diabetes is critical to learning. When a child is experiencing highs or lows in the blood sugar reading this can create disruptions and make it hard for them to concentrate and learn. The teachers or other support personnel are going to need instruction for handling your child's diabetes and what to do in case of an emergency. For a child with a low blood sugar it is important that their blood glucose level is checked and that they have something to eat. For a child with a high blood sugar, their blood glucose will need to be checked too and a decision has to be made whether or not to give insulin. This is a big responsibility to hand over to another adult and can be nerve-racking for parents. An emergency kit should be with your child at all the time with instructions on what to do to help if something is wrong. Included should be a snack, a food item or glucose tablet that is fast acting (gets sugar into the system quickly), a list of emergency numbers to call, and a glucose monitor. A teacher or school nurse should be designated as the person responsible for your child while at school and they should have a back-up in case they are not present for a day or more. Getting Back on Track after Blood Sugar Spikes Even with careful planning your child is going to test with high blood sugars -- but hopefully not too frequently. There are many reasons for this, including not taking insulin on time or enough, eating too much, not exercising enough, and stress. High blood sugar in children does not occur as quickly as a low blood sugar will. You may find that over the course of a day or couple of days that your child's blood glucose levels are creeping upwards. Signs that high blood sugar is becoming a problem is your child needing to urinate more and an increased need to drink (very thirsty). Over time, elevated blood sugar can cause serious damage to eyesight and other organs including the kidneys. With the increased urination, dehydration is also possible if enough liquids are not taken in. If over the course of a day, your child's blood glucose levels do not return to normal an increase in their insulin dosage may be required. If you have been managing your child's diabetes for some time you may be comfortable making these adjustments yourself. If not, call your doctor and get advice on what adjustments need to be made and whether they are long or short term changes. Evaluate your child's diet too. Have there been any foods that have been introduced recently that could be causing the problem? Other factors to consider is if your child is ill (some medications can raise blood sugars), and has your child been less active in the past couple of days. If your child's body is used to regular physical activity, by being sedentary your child's blood glucose levels will be higher. Until the blood glucose levels return to normal, ensure that your child is getting plenty of fluids -- the sugar free kind is the best choice. Traveling and Juvenile Diabetes Planning on a family vacation? Don't worry trips and other family outings do not have to be restricted because your child has been diagnosed with juvenile diabetes. You can do it all still but there are some extra preparations and planning that will have to happen first. The preparations you make is going to be dependant on what kind of trip you are planning, for how long and the activities that you will be participating in. It is a good idea if you are going out of town on an airplane or by car to get some documentation from your doctor. You should get a letter that explains your child's condition and an extra prescription for any unforeseen eventualities. If you are going on a lengthy plane ride, you will need the letter to get permission to bring your child's medicine and syringes onto the airplane with you instead of storing them in your luggage. If you are unsure what special arrangements you are going to need to make, speak to your doctor. If you are going on a vacation that will involve lots of extra physical activity (such as camping or hiking), be sure that you bring extra food to replace the energy that is going to be used up. If there is going to be less physical activity, more frequent testing of blood sugar levels will be necessary to make sure too much insulin isn't being used. When traveling a distance that involves crossing different time zones, be prepared to make additional adjustments to your child's eating schedule. No matter what the clock says, your child is going to need their insulin and food on their body's time. Again, your doctor can help you make a plan for this adjustment and it will be based on the length of your trip, the difference in time zones, and your child. The Symptoms of Juvenile Diabetes If diabetes runs in your family, you may already be aware of the symptoms to look for to see if your child might have juvenile diabetes. If the disease is prevalent in your family, your doctor may run routine screening tests as a precautionary measure in the form of blood work. But this isn't always the case. If your child exhibits any of the symptoms listed below you should schedule and appointment with your health care provider to have them looked into. If your child is exhibiting these symptoms, they could be a sign that he or she has juvenile diabetes: * Extreme thirst -- this can be defined as a need to drink constantly without be satiated. * Going to the bathroom to urinate more than usual. In some cases your child may wet the bed because of the increased need to urinate. * Vision difficulties. Your child is complaining that they cannot see things properly or that they are blurry. * Losing weight, you may notice a sudden drop in your child's weight that is not linked to any other causes such as a recent bout of the flu. * Mood changes, the highs and lows of your child's blood sugar can cause them to be grumpy or bad-tempered with little provocation. * A constant desire to eat, this is considered a symptom when the amount of food your child wants to eat is more than normal. * Suffering from stomach aches or pangs with or without vomiting. All of the above symptoms could mean that your child has diabetes but only blood work ordered by your doctor will prove that. Another point to note is that the above symptoms do not develop over time; it may be quite obvious to you that something is amiss as these changes can happen quite abruptly.
The Risk Factors for Juvenile Diabetes Although there is no known cause for juvenile diabetes there are risk factors that can contribute to the likeliness a child will be diagnosed with the disease. As some forms of type 1 diabetes are an autoimmune disease you can be at a higher risk if you have already been diagnosed with a different autoimmune disease. There are also some conditions surrounding a mother's pregnancy and labor than could contribute to the diagnosis of juvenile diabetes. If your child has been diagnosed with one of these autoimmune disease he or she is considered at a higher risk for diabetes in childhood: * If your child has had one of these viruses: hepatitis, mumps, or CMV disease * Thyroid problems known as hypothyroidism or hyperthyroidism (or Graves disease) * Celiac disease There has been some evidence that has shown that a child born to a mother over the age of 35 could be at higher risk for developing type 1 diabetes. This is not conclusive and it is not to say that a child born to a younger mother is not at risk as well. Some studies indicate that a mother who had pre-eclampsia during pregnancy will give birth to a baby with a higher risk of being diagnosed -- but this is not a proven fact. Other risk factors include race -- people from Northern Europe or areas of the Mediterranean -- are considered at higher risk than other races. Environmental and dietary factors can play a role too. If a child is under a lot of stress it is considered a reason why he or she may go onto develop type 1 diabetes. Dietary risks factors include high levels of dairy and nitrosamines (used as a preservative in some meats and cheeses). Exposure to toxins is considered a risk factor too. Support from Friends and Family Telling friends and family about your child being diagnosed with juvenile diabetes may bring about mixed emotions. You don't want your child to be pitied, you don't want them to be looked at differently, yet you do need people to understand that your child will need some special considerations sometimes. When you first tell people they will either provide positive support, be neutral, or there may be some negative reactions. The first two reactions are not a problem, you may get offers of support or it may be a non-issue for others. It is the naysayers you need to be careful of. You know it is a serious disease and you need to be sure your child is aware of it too but you don't need outsiders bringing doom and gloom into the situation. There are tools and support to manage diabetes and your child can still expect a full and happy life. The easiest way to deal with negative reactions from friends and family members is to educate them. Most times they have an incorrect impression of what diabetes is, how it is managed, and the long-term effects. It is serious but damage can be minimized with good control. Your child may be nervous telling his or her friends too -- afraid that they will be looked at as different. Most children will have a neutral reaction or none at all. It is not something that will affect friendships and it is not a problem. If your child does suffer from teasing or taunting because they cannot have candy or some other silliness -- let them talk to you about it and express their feelings. Some of their friends may have questions and some may not. If there is a concern with how your child is being treated or how the diagnosis will be received speak with your child's teacher. Juvenile Diabetes in Younger Children When younger children are diagnosed with juvenile diabetes is can be very hard on them. They may not understand the severity of the disease and all of the restrictions that are placed on them. It is going to take patience and time for them to get used to their new lifestyle and the changes that go with it. Here are some tips to make the transition a little easier. Join a support group of other parents whose children have been diagnosed with juvenile diabetes. There experience in dealing with situations that you are going through can help to give you ideas and let you know that you are not alone on this journey. Not only can this type of group benefit the parents, it is for the children too. It will be beneficial for them to have friends that have diabetes too. As they grow older, these friendships can last a lifetime based on the common link of juvenile diabetes. In the beginning especially you may feel guilt because you are constantly saying no to your child. It is for their own good that they can't have treats whenever they want but it doesn't make it any easier. Steel yourself against the cries, begging, and whining that may ensue and know that it will get easier as time goes on. Change is difficult for many including kids. As your child get older and has more experience under their belt, involve them in the process of managing their diabetes. This will help them feel more in control of their disease and as the same time prepare them for the time when they are going to be on their own and have to take care of their own injections and blood glucose monitoring. Each child is different and is going to handle the changes in their own way. Be their to support and help your child in whatever way they need. Juvenile Diabetes and the Honeymoon Period In many children with juvenile diabetes a period occurs shortly after being diagnosed they go through what is commonly called as the honeymoon period. This is a time when your child's blood sugar levels will return to normal without the aid of additional insulin. It is important to remember that this happens in a lot of children and does not mean that the disease has gone away. The pancreas is still trying to do its job and is working overtime to make insulin for your child's body. Following are some guidelines to follow when this happens. The length of the honeymoon period is not the same for everyone. In one child it can last months while in another child it can feasibly last for over a year. It all depends on how much insulin your child's pancreas can produce and how long it can keep up that rate of production. It will be hard to figure out how much if any insulin your child needs during this time when their blood sugar levels are normal. Constant monitoring of the blood glucose levels is still required, because you will not know when the honeymoon period is over otherwise. Keep in close contact with your health care provider. He or she will help in determining what the best plan is to follow during the honeymoon phase. Some may even want you to give minute amounts of insulin daily in order to keep your child used to the injections and your child's body accustomed to the additional insulin it will need. It can be emotionally hard for your child during the honeymoon phase. Everything will seem back to normal and they are going to want to resume their life like it was prior to diagnosis. It is important to remain on the diabetic diet and continue monitoring during this time. Juvenile Diabetes and Teenagers Teenagers are young adults and are ready to take on new responsibilities. If your teenager has had juvenile diabetes for some time, this is the time to pass the reins of management over to them. It may seem a bit intimidating to you to let your child take control of their diabetes but it is the best thing you can do for them. They are approaching a time in their life when they are going to be going out on their own. For both your sake and theirs, a comfort level needs to be reached in reading blood sugars, giving injections and planning appropriate meals. If your child was a teenager when he or she was first diagnosed, involve them in the process from the beginning. Their input and the ability to make some decisions will help them feel in control of a situation they would rather not be in. The biggest point to stress and make sure your teenager understands is how important it is to keep proper control of their diabetes. Juvenile diabetes is a serious disease and it has serious complications if blood sugar levels are not kept under control. Discuss with your child different scenarios that are sure to arise and try and come up with solutions or ways to manage them. Drinking can have a negative affect on blood glucose levels and it is important that a young adult realize the dangers. When they reach legal age, they need to know how drinking can affect them and ways to incorporate that into their life if they so choose. As a parenting, letting go is a hard thing to do but it is necessary to create independent adults. Trust your child to make the right decisions for their diabetes and be there to guide them when necessary. Insulin Pumps for Juvenile Diabetics A popular alternative, especially for teenagers, to daily insulin injections is to use an insulin pump. Although it is an alternative for everyone because of the high cost of the unit and having to wear it 24 hours per day for others it can help in successfully managing juvenile diabetes. An insulin pump is worn all the time and provides a steady stream of fast-acting insulin instead of a combination of fast-acting and long-lasting insulin that is typically combined in a syringe. If your child is has to have multiple needles in a day this is also an attractive alternative. Wearing an insulin pump provides greater flexibility; there is no specific injection and eating times that have to be met. But eating at similar times each day is still recommended. One of the best features of wearing an insulin pump is the ability to bolus -- giving additional fast-acting insulin immediately before eating a meal or a snack by pressing one of the buttons on the pump. This method can prevent spikes in blood sugar by providing a boost of insulin when it is needed most. Some of the downsides of a pump are the expense. The unit itself is not cheap and you have to still buy the insulin and supplies to go with it. And it has to be worn all the time with the exception of bathing or swimming. But you and your child will have to weight the pros and cons of a pump and see what they want to have in the end. The same amount of effort is still needed to keep blood sugars in control but having an insulin pump can be more convenient by not having to worry about insulin injections. An insulin pump will also keep a steady stream of insulin in the body overnight when blood sugars can sometimes spike. Hypoglycemia Hypoglycemia is when a child (or any other person) with diabetes is suffering from low blood sugars. This can be an extreme and dangerous situation and in the worse case scenarios can lead to a diabetic coma or even death. But with careful monitoring of blood sugar levels this can be prevented. An important lesson to teach young children with juvenile diabetes is to recognize the signs of when they have low blood sugar. For very young children this is going to be difficult when they don't have the words or comprehension to explain what they are feeling. Your child can develop hypoglycemia if they have not eaten enough, have had too much insulin or if they have missed a meal. All of these situations can be avoided but they still happen from time to time. Make sure your child always has some emergency food on hand for these types of situations and knows when they should eat it. A child suffering from hypoglycemia may display certain symptoms that can help an outsider know what is going on. Especially for young children keep a look out for mood swings, shakiness, paleness, acting strangely or the inability to concentrate. The condition can manifest itself in many different ways but in an individual they usually react the same way to hypoglycemia. Learn how your child reacts to low blood sugars and advise others who care for your child in the course of a day so that they too can be prepared. If your child is frequently suffering from hypoglycemia, consult with your doctor or diabetes educator. An adjustment to the insulin schedule or the amount of insulin that is given may need to be adjusted. A closer look at the meal plan is warranted too, maybe meal times or the type of food eaten needs to be changed. How Juvenile Diabetes is Diagnosed It can be scary when you realize that something may be wrong with your child. You will want to find out right away what it is and how you can help. The testing that is done to determine if your child has juvenile diabetes is not very evasive and can be determined in a very short period of time. Once you have taken your child to your health care provider, blood work will be ordered to check your child's blood glucose levels. The first test that is performed is normally a with a blood glucose monitor in your doctor's office. If the level is high a fasting blood glucose test will be ordered. Your child will not be able to eat for 8-10 hours prior to the blood being drawn. It is best to do this first thing in the morning as soon as your child wakes up. Bring a snack along for your child to eat after the blood work as they are sure to be hungry. Depending on the results from the fasting blood test your doctor will probably order another round of tests to verify the results. This test is also done on an empty stomach and you should make an appointment as you will have to be in the office from 1-3 hours. When you arrive at the lab your child will have some blood drawn and then be asked to drink a beverage that is high in sugar. After one hour another blood test will be conducted to see how your child's body has processed the sugar. If the three hour test was ordered two more blood tests will be done at the two hour and three hour marks. The results from this test will give your doctor the information needed to make a diagnosis of juvenile diabetes in your child. Help from Grandparents with Diabetic Children A night out on the town is just what mom and dad needs, but who is going to baby sit? Grandparents are the best baby sitters, especially when they involve an overnight stay. For parents of children with juvenile diabetes it might not be as easy. It is going to be hard to leave your child with anyone for an extended period of time unless they know how to take of your child and manage their diabetes. Training and a little bit of practice is all that is needed. The good thing about grandparents is that you know they have your child's best interests at heart. They are going to take the responsibility seriously and follow your instructions to the letter. To give the grandparents confidence and make yourself feel better do a trial run. Have a day where you are around and let grandma or grandpa take the reins for the day. It doesn't take much time to become comfortable with drawing and injecting the insulin and testing blood sugar levels with a monitor. For the first visit, help out by providing a list of step-by-step instructions as a back-up. And you can even provide meal suggestions. Send your child with their emergency kit (they really shouldn't go anywhere without one anyway) and make sure everyone knows how and when to use the contents. Leave contact numbers where you can be reached at all times. It will give peace of mind to everyone involved to know that if any questions arise or an emergency does develop you are just a phone call away. Encourage the calls so that no one feels that they are interrupting you -- even for little questions. After the first successful overnight stay, be ready for many more requests to go and stay at grandma and grandpa's house for a sleepover. Healthy Eating Guidelines for Juvenile Diabetes A daily insulin injection is required to manage type 1 diabetes in children but it is not the only management strategy. The diet plan that goes along with the daily insulin requirements is just as important and needs to be planned accordingly. Consistency in meal times, portion sizes, and food groups are the keys to successful meal planning for children with diabetes. Even though consistency is of the utmost importance, it does not mean that your child cannot have variety too. This may seem impossible but there are ways it can be achieved. The important rules to remember are feeding your child at the same time each day and giving them their insulin injection(s) at the same time too. This helps their bodies regulate the use of the insulin. The other piece of the consistency equation is the servings given from the food groups. If your child gets one protein and one carbohydrate every day for the morning snack don't deviate from that. But what you can do is provide many choices for the protein and carbohydrate and try different combinations. If your child has a favorite meal or snack that works well with their blood sugar make it for them as often as they like. But they are going to get bored if they have to eat the same thing day in and day out. You are going to find that the food choices available are not as limited as you might have originally thought. You can also get creative and revamp old recipes making them friendly for diabetics by using sugar substitutes in place of sugar or using whole wheat in place of white (for instance in a pizza crust). Browse diabetic cookbooks with your child and involve them in the meal planning. You are sure to have more success in preparing meals if they have a say in what they are eating. What do to when a Child with Juvenile Diabetes gets Sick It's never fun when a child gets sick with a cold or flu. They don't feel good, sometimes get grumpy and need to be taken care of. This is true for a child with juvenile diabetes too, but there is the added concern of how their blood glucose levels will be affected by the illness. This is just another hurdle to deal with once your child has been diagnosed with diabetes. If you are giving your child an over-the-counter or prescription medicine be sure to read the labels and warning or talk to the pharmacist. Some medications will cause a child's blood sugar to be elevated and this should be taken into account when planning insulin dosage and meal plans. If your child is sick and has no appetite or is vomiting, it is still important that they take their insulin. By testing their blood sugar frequently you can determine an adjusted amount of insulin to give them but don't skip it entirely. If your child's blood sugar is too low and they cannot eat anything try giving them a soda that is not sugar free. Keep in mind that when your child is ill or stressed (or both) their blood sugar will be raised by that alone. If you are unsure how to help your child or you cannot get their blood sugars under control, call your doctor for advice. When your child is sick, check their ketones more often than just in the morning when they have fasted. If they are not eating because of nausea they could be spilling ketones into their urine and suffer from ketoacidosis. This is a serious condition that needs medical attention. Make sure your child is receiving their regular insulin injections and are drinking plenty of fluids in order to prevent this condition from developing. Type 2 Diabetes in Children The type of diabetes the majority of children are diagnosed with is type 1 diabetes. Type 2 diabetes is associated with the disease when it is diagnosed in adults -- also called adultonset. There are cases of children being diagnosed with type 2 diabetes and the numbers are growing. A big contributor to the increase in these numbers is poor lifestyle and diet choices for our children. But this is not the only cause and may not be the cause at all for some. Just because a child is overweight or eats unhealthy does not mean he or she will get type 2 diabetes. Although, these lifestyle choices are factors that can increase the chances of it happening. Symptoms or factors that are present in children who have been diagnosed with type 2 diabetes include the following: * A child who is over their healthy weight range or is considered obese * Many members of the family have been diagnosed with diabetes (most times this will include one of the parents) * Some of the same symptoms shown in type 1 diabetes may appear with type 2 diabetes as well -- increased urination (frequency), unquenchable thirst, and feeling very lethargic Some children will show none of the above signs and it can be hard to diagnose them with type 2 diabetes. Annual check-ups with your doctor are important. Discuss with your doctor your family's medical history. If there is diabetes present in your family members your doctor may want to run routine tests even in the absence of additional signs or symptoms. The treatment for this type of diabetes is sometimes the same as type 1 diabetes. In some patients, they will have to take an insulin injection every day. But, with type 2 diabetes, depending on the severity of the disease, it is also possible to control blood glucose levels with diet and exercise alone.
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